medical billing coding instructor resume example

• Assessed medical codes on patient records for accuracy.
• Reviewed medical records to meet insurance company requirements.
• Maintained knowledge of new or revised codes and industry regulations to complete accurate coding services, including local coverage determinations.
• Recorded, stored and reported medical coding information to create statistics of healthcare encounters.
• Interpreted medical terminology and pharmacological information to translate information into coding system.
• Expertly assigned charges and payments for medical procedures.
• Sought clarification from physicians and other hospital personnel for answers to any needed coding interpretations prior to abstracting records.
• Reviewed all claims for accurateness and appropriateness.
• Reviewed account information to confirm patient and insurance information is accurate and complete.
• Answered patient calls, identified issues and determined how best to provide assistance within parameters established by facility and supervisor.
• Reviewed accounts to determine payment plan compliance.
• Notified customers of delinquent accounts with attempt to collect outstanding amounts.

• Reconciled clinical notes, patient forms and health information for compliance with HIPAA rules.

• Assigned value codes and modifiers to provide specific information for services provided.

• Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.

• Reviewed clinical data from medical records to assign ICD, CPT and HCPCS codes. Interpreted medical terminology and pharmacological information to translate information into coding system.

• Reviewed clinical documentation for submission and authorizations for Medi-cal, CCS and DHCS.

• Worked closely with clinical trials and research study related accounts for accurate clinical documentation for billing and collections.

• Increased team efficiency by assisting Senior Manager with the implementation of new healthcare software- EPIC during go-live. Nominated as a Super User as the forefront of the Revenue Cycle Department to teach and train staff on Epic healthcare system.

• Investigated billing discrepancies and implemented effective solutions to resolve concerns and prevent future problems.

• Researched and communicated insurance requirements, including patient financial responsibilities and eligibility.

• Billed and submitted insurance claims for Workers Comp, Managed Care, Medi-cal, Medicare and all Commercial payors including submission of provider disputes due to underpayment and or erroneous denials. As well as, prepared and submitted Medicare quarterly report for late charge adjustments.

• Enforced policies and procedures according to compliance with federal and state guidelines.

• Monitored aged accounts and billing discrepancies and created detailed reports for senior management.
• Detailed all key revenue cycle information into thorough presentations to deliver to executives and the management team.
• Presented regular status updates on AR collections, including workflow recommendations to senior management.
• Boosted job efficiency by working closely with other analysts so that tasks and processes could be streamlined and duplication of billing was avoided.
• Audit AR and payment posting to determine true AR collections on a monthly basis.
• Follow-up on appeals and provider disputes until account resolved.
• Set up and monitored payment plans and processed payments for cash patients.